Daytime resting periods in neurorehabilitation

Simon Kjeldsen, Federico Gabriel Arguissain, Jørgen Feldbæk Nielsen, Ole Kæseler Andersen, Iris Brunner

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    Abstract

    Introduction Patients undergoing rehabilitation after severe acquired brain injuries (sABI) are offered several daytime resting periods (DRPs) each day. DRPs are supposed to consolidate the patient’s motor and cognitive learning processes and to counteract fatigue. These potential effects depend on the quality of the rest achieved during DRPs. Therefore, it is of interest to assess whether quality of rest is measureable in patients who cannot express themselves. To date, no clinically feasible systematic measure of quality of rest has been documented for use in patients with sABI. To evaluate quality of rest, this study explores the possibilities of using staff assessments and objective measures, such as heartrate (HR), measured by electrocardiography (ECG), and motor activity, measured by accelerometer (ACC). Objectives Our aim is to develop a statistical model based on ECG and ACC measures to predict quality of rest as assessed through staff observations. Patients & methods This is an observational study. Patients are recruited from a subacute rehabilitation ward and screened for eligibility according to set criteria: 1st admission to the rehabilitation hospital, referred due to sABI, ≥18 years old, ≤ 7 on the levels of cognitive function scale, closest relative noted in record, not terminal ill, no spinal lesions and absence of paroxysmal sympathetic hyperactivity. Subjects are monitored for 20 days during DRPs. We have implemented a simple staff-administered clinical assessment (CA) for assessing quality of rest. The CA is an ordinal scale containing the categories of quality "Very good" "Good", "Bad", "Very bad" and "Insufficient information to assess quality of DRP". The staff document the CA's after each DRP. The predictive value of the independent variables is analysed. The independent variables are patient characteristics and objective measures of ACC and ECG recorded during the DRPs. From ACC, the motor rest ratio is derived as the percentage of time resting during a DRP. From ECG, the mean HR, HR/Resting HR and selected HR variability estimates from the time domain and the power spectrum are calculated. Results Results are pending. Status per April 15th 2019 is that 21 subjects have been included. Discussion Models that allow evaluating the quality of rest in patients with sABI could be an important contribution to document overall improvement and furthermore guide rehabilitation staff in regards of timing of the DRPs.
    Original languageEnglish
    Publication date10 Oct 2019
    Publication statusPublished - 10 Oct 2019
    EventEuropean Congress for Neurorehabilitation - Budapest Congress Center, Budapest, Hungary
    Duration: 9 Oct 201912 Oct 2019
    https://www.ecnr-congress.org/

    Conference

    ConferenceEuropean Congress for Neurorehabilitation
    LocationBudapest Congress Center
    Country/TerritoryHungary
    CityBudapest
    Period09/10/201912/10/2019
    Internet address

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